Impact of downsizing VA is more than just politics

While political proposals that could downsize the Department of Veterans Affairs (VA) get bandied about Washington, DC, veterans across the country are experiencing what a smaller role for the VA would mean.

In Nebraska and Iowa, for example, elderly veterans who rely on adult day care and non-skilled nursing care have been told this benefit will go away on August 1. In Idaho, an outreach center where homeless veterans go for a shower and help looking for a job may soon be shuttered. In Denver, a nursing home, post-traumatic stress disorder treatment center and medical research site have been eliminated from the new medical center. And at many VA healthcare facilities across the country, veterans are being told there just aren’t enough doctors and nurses to see them anytime soon. It’s all due to severe budget shortfalls facing the VA – evidence of what can happen when seeking political points and media coverage become more important than making sure America’s veterans get the healthcare and benefits they earned, and were promised.The VA has faced unyielding criticism for the past year, much of it deserved. From a management perspective, what has transpired at some VA health care facilities is inexcusable. But what has not changed is the fact that veterans need the specialized, unique care that is only found at the VA, the proven leader in preventative care for veterans and world renowned for treating PTSD, spinal cord injury, blindness, amputation, and other injuries related to military service. The number of veterans seeking this care has reached record levels. The New York Times recently reported that VA doctors and nurses have handled 2.7 million more appointments this past year than in any previous year, even while authorizing 900,000 patients to see non-VA medical personnel. Some VA hospitals have seen their patient roster grow by as much as 18 percent.For years, DAV (Disabled American Veterans) and other veterans service organizations have warned Congress and the administration that VA healthcare is dangerously underfunded, that appropriation levels were insufficient to hire enough doctors, nurses and specialists. As far back as May 2003 a presidential task force confirmed the mismatch between demand and funding. Unfortunately, the response has not been a reasoned examination of what it will take to build a healthier VA. More often than not, the response has been indifference. This past year, as problems with waiting lists and access to VA dominated headlines, the response, when it comes to addressing long-term resource issues, was marginal at best.

Fixing the VA is not just about money, though Congress and the administration must rebuild the VA’s capacity to provide timely healthcare to veterans. It’s also about restructuring non-VA care to increase access, realigning VA’s delivery of care to meet the needs of all veterans, and reforming VA management and culture. And it’s about time—otherwise, more and more veterans are going to experience the reality of a downsized VA.

Augustine, a Vietnam-era combat-wounded Army veteran, is executive director of DAV's Washington Headquarters.
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